Questions to Guide the Interview

Questions to Guide the Interview:

Questions to Guide the Interview

  1. What nursing licenses does the APRN have (Texas RN and APRN) and in what APRN role(s) and population foci does the Texas BON authorize this APRN to practice (Family)?  How long has the APRN been practicing in this APRN role and population focus area (3 yrs)?  In what practice is the APRN currently working and did you observe the APRN in that setting (Adult Oncology/YES)? How long has he or she been in their current position (3 yrs)?
  2. Where did the APRN obtain his/her post-basic RN training as an APRN (UT Arlington)? Was the program an accredited certificate program, an accredited Master’s level program or an accredited DNP program (an accredited Master’s level program)?  In what ways did the APRN feel, or not feel, prepared to practice when they graduated (After I graduated, I started working in inpatient oncology setting and most patients are being admitted with acute/critical needs. I felt unprepared for the role as I do not have a lot of experience in emergency and critical care settings. My study focus is Family care. I moved to outpatient after 8 months, which is less demanding in terms of patient needs). Compare the ways in which the APRN did or did not feel competent to the core and population competencies applicable to the APRN’s practice, i.e., NONPF core and population competencies for NPs). What does the APRN wish she had known when beginning practice that their educational program did not teach them (I wish I had studied Adult Acute Care NP)?
  3. Is the APRN certified (yes)? If so, with which certifying body and how does he/she document those credentials after the APRN’s name? (ANCC, NAPNAP, AANP, NCC, ONC) , (AANP, ONC)? For example, WHNP, CPNP, CS, BC? How often do they recertify and what is the process and requirements for certification (AANP-5 yrs, ONC-4 yrs)? Could the APRN have certified with a different certifying body? If so, explain.
  4. How does the APRN document his/her name and title in the medical record (Jane Doe, ARNP)? Does the signature meet current BON requirements? Questions to Guide the Interview
  5. Who is the APRN’s employer (St. Lukes Hospital)? Does the APRN see patients in multiple practice settings(No)? Describe each setting and the APRN’s role in that setting (Adult outpatient setting). What is a typical day for the APRN (I support 3 attendings. I see adult oncology patients who have Plasma cells diseases including multiple myeloma, smoldering multiple myeloma, MGUS, AL amyloidosis, and Waldenstrom macroglobulinemia. I see them in every stage of their disease, that is, newly diagnosed, relapsed, post stem cell transplant, and end of life)?
  6. Who is responsible for making practice decisions in the APRN’s work place (Collaborative when patients are newly diagnosed and with change in disease status and needing to transition to a new regimen. I have the autonomy to make my own decisions on a day to day basis and I don’t have to report to my attendings all the time. I also meet with my team once a week to discuss patients that we saw during the week for plan and updates on how they are responding to treatments) ? Is this done by one person or is it a formalized collaborative process (collaborative team meeting with attending, clinical nurse, and scheduler)?
  7. Does the prescription form meet the legal requirements, or if prescribing electronically, is the APRN able to “sign” the prescriptions and include other required information (I am able to prescribe electronically which reflects my NPI number and DEA for controlled substances)? Does this APRN prescribe controlled substances (yes)? If so, what schedules does the APRN order or prescribe and what steps has the APRN taken to comply with the controlled substances laws (I prescribe schedule 2, 2N, 3, 3N, 4, 5. I educate them about the risk and side effects of the drugs if they are opioid naïve. I reassess the patient’s continues need for controlled substances and make appropriate changes including taper and weaning off. I check the PMP every time I refill their prescriptions to make sure there is no multiple prescribers and the patient is getting appropriate numbers of refill. I also refer them to pain clinic when they have uncontrolled pain and their above the 120mg MED dosing threshold.
  8. How are the services provided by the APRN reimbursed—under the APRN’s provider number or under the physician’s (APRN’s provider number)? If the APRN’s services are billed under the physician’s provider number, how does the practice ensure their billing is compliant with applicable laws such as Medicare incident to billing guidelines (I only bill under my attending if I am doing a shared visit with him for new patients. I used the visit code and appropriate diagnosis)? If billing under the APRN’s provider number, in how many managed care (MC) plans is the APRN a provider (the entire clinic visit with treatment plan including their primary disease and treatment, maintenance and supportive therapies, and some chronic diseases that are stable)? Did the APRN or employer encounter problems during the credentialing process (No)? If the APRN is a primary care provider (PCP), is the APRN identified as a PCP on the MC plans (Not sure how to answer this. But I always include my attending as a “Primary oncologist” in my visit note, but my note shows as an independent provider during the visit)? How does the practice ensure billing is compliant with applicable laws (I use the billing code for the visit and appropriate diagnosis billing code)? Questions to Guide the Interview
  9. Does the APRN have personal malpractice insurance, or is he/she covered by the institutional or practice’s blanket policy (No personal malpractice insurance. I’m covered by my employer’s blanket policy)? Is the APRN’s malpractice policy occurrence or claims-made (occurence)? What are the advantages/disadvantages of each type of malpractice policy? Which type is recommended? Why?
  10. What is the APRNs philosophy of care (Collaborative and holistic patient and family centered care. I educate them about their disease and always tell my patient and their family that we are a team and that they should be an active participant in their medical care. I am sensitive to their values and beliefs. I make sure that I don’t impose my own)? Based on your interview and analysis, what nursing theory best describes the APRN’s practice. (You may include this in your conclusion)
  11. How does the APRN keep current regarding the BON rules/regulations for APRNs in the State of Texas (By renewing licenses and acquiring required CME hours)? To what journals does the APRN subscribe and what other strategies does the APRN use to maintain clinical competence (I subscribe to different journal to review updates and new treatments relevant to my area of practice including Clinical Advances in Hematology & Oncology, The Nurse Practitioner Journal, Journal of the Advanced Practitioner in Oncology (JADPRO), and individual articles and journals related to my area of practice. I also use NCCN, UpToDate, Micromedics, Epocrates, Medscape, USPSTF for guidelines)? To what APRN organizations does the APRN belong for professional involvement (AANP and JADPRO)?  How does the APRN get involved in APRN/nursing leadership/policy/legislative activities (not involved)(i.e. giving money, time).
  12. Does the APRN use any tools or standards to determine his/her ongoing competence to treat the APRN’s patient population (Yes. Along with our institution guidelines, I utilize NCCN and peer reviewed guidelines in UpToDate. We also review and include research studies treatment relevant to our patient population. We are also required to get credentialed to see patients on clinical studies through our organization) ? What process and/or documentation does APRN use if expanding the competencies the APRN currently has (e.g., a professional portfolio)? Does this method meet BON requirements? Is the APRN functioning within his/her scope of practice (yes. Per Texas state rules and regulations)? Why or why not? In what ways do you think this APRN meets, exceeds or fails to meet the standards of care? Questions to Guide the Interview

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